Exercise in pregnancy

“Eating alone will not keep a man well; he must also take exercise. For food and exercise… work together to produce health.” Hippocrates,
CA. 400 B.C.

Over the past decade or so it has become more and more clear that a good diet alone does not guarantee good health. Rather,
good health results from a combination of genetics, diet, lifestyle and activity or exercise. Recent studies have shown that exercise is beneficial for your heart, lungs, arteries, blood
pressure, muscles, bones, metabolism and for your nervous system. This is especially true in pregnancy, with a host of added benefits.

Although the baby’s heart rate does increase by 5-25 beats per minute when a woman exercises, this has not been found to cause any damage or dangerous stress to
the fetus.

No harm has been documented due to the rise in the mother’s temperature related to exercise.

Studies have shown that exercise later in the pregnancy does not cause preterm delivery. In fact, women who exercise straight through their pregnancy have
shorter labors and few perinatal complications.

(Riemann & Kanstrup-Hansen, 2000)

Like everything else, there are some rules…

Warning Signs:
Stopexercising and call your midwife if you have any of these symptoms:

Vaginal bleeding

Dizziness or feeling faint

Increased shortness of breath

Chest pain

Headache

Muscle weakness

Calf pain or swelling

Uterine contractions

Decreased fetal movement

Fluid leaking from the vagina

Ask your midwifeto modify your exercise
routine to your needs if you currently have or have a history of:

Hypertension

Anemia

Thyroid disease

A sedentary life

Known cardiac or respiratory illness

History of bleeding during a previous or current pregnancy

Placenta previa after 26 weeks

Twin pregnancy

Pregnancy induced hypertension

Insufficient cervix

Preterm rupture of membranes or preterm labor

Intrauterine growth restriction

A history of delivering a small for gestation baby

(ACSM & ACOG)

Your Exercise Plan

The Exercise Plan by the American College of Sports Medicine, the American Heart Association and Harvey Simon from Harvard Medical
School. (Harvey, 2006) (Jonas & Phillips, 2009)

There are four parts of a holistic exercise plan. Each section can be modified to your level of need and ability, so look at these
lists and diagrams and start filling in your exercise chart.

1. Cardiosuch as
vigorous walking, running, biking or swimming is the part of the exercise routine where you get your heart and respiratory rate above its resting speed. The more you can do, the more you and the
baby will benefit, but even a little something is better than nothing, so give it a go and see what you can accomplish.

How much and how often:

oModerate: moderate-intensity (which
means your heart rate is up, you are sweating, but you can still talk) a minimum of 30 minutes a day five days a week. A brisk walk counts as moderate-intensity, so make a goal and start walking
toward it.

oVigorous: If you have been
exercising vigorously prior to pregnancy, it is still safe to do so until your body tells you to slow down. If you are in this category you need to exercise vigorously three times a week
for twenty minutes. As you begin to slow down, lengthen the duration and number of sessions per week to keep up your cardio health.

2. StrengthTraining makes your joints, muscles and bones strong and healthy, especially for women, who tend to lose more bone density
with age than men. Strength training is most commonly known as weight lifting (with dumb bells or weight machines) but can also be from resistance training (elastic bands) or yoga.

3. Stretchingis necessary for
strong, stable and flexible joints. This is especially true in pregnancy as the pregnancy hormones loosen your joints to get ready for the passage
of the baby through the pelvis. An inflexible or too loose joint is more likely to be injured when pushed or pulled during movement or exercise which may cause strains (injury to a muscle or
tendon) or sprains (injury to the bone). Stretching can improve posture and your ability to exercise safely as well as help release tension and promote relaxation.

How much and how often:Stretching is
one area where we do not have good evidence or clear rules regarding how many stretches and how often. Many suggest stretching prior to exercising to warm up and after exercise to cool down.
Alternatively, a daily stretch can be part of your labor preparation – take a moment to relax and breathe for your physical and mental wellbeing.

4. Balanceis more about safety
than about building a strong happy baby. In pregnancy your center of gravity is changing weekly, and while you may not wake up one morning and notice it because you adapt as it changes, your
center of gravity is changing immensely. It is because of this balance chance that we do not suggest you hop on a bike in mid-pregnancy if you’ve not been biking regularly up until that point. It
is not the bike or exercise that is dangerous, it is the change in your center or balance point that causes risk. If you haven’t been on a bike for months, try a stationary bike instead, the
reclining ones even have space for your belly.

How much and how often:if your balance
is in good form today, you don’t need to do specific exercises for balance, but do try to be aware of your balance limitations as the pregnancy continues.

5. Keep it Safe: Be sure to
stay hydrated, avoid prolonged periods of overheating and be realistic about what to expect as the pregnancy progresses.